Patient Safety, Anesthesia, and Perioperative Management
Core concepts
Know airway assessment (Mallampati, thyromental distance), difficult airway algorithms, VTE prophylaxis, surgical site infection prevention, and local anesthetic maximum doses. Understand fire safety in the operating room and positioning injuries.
Traps in questions
- Forgetting the maximum dose of lidocaine with epinephrine (about 7 mg/kg) versus without epinephrine (about 4.5 mg/kg).
- Missing the fire triad (oxidizer, fuel, ignition source) in head and neck surgery.
- Assuming all patients need the same VTE prophylaxis; risk stratification matters.
- Overlooking the difficult airway in patients with head and neck cancer or prior radiation.
Rule of thumb
In the operating room fire triad, stop the oxidizer first (turn off oxygen), then remove the burning material and cool with saline.
Worked example
During tracheostomy, a spark ignites near supplemental oxygen. The question asks the first step. The rule: stop the flow of the oxidizer by disconnecting oxygen, then extinguish and cool. Reaching for water before stopping oxygen is the wrong sequence.